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Similarities Differences

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									Increasing Hepatitis B Screening Among
       Korean Church Attendees

 Roshan Bastani, PhD        Principal Investigator
 Vicky Taylor, MD, MPH      Co-Principal Investigator (FHCC)
 Beth Glenn, PhD            Co-Investigator
 Annette Maxwell, DrPH      Co-Investigator
 Angela Jo, MD, MPH         Co-Investigator
 Weng Kee Wong, PhD         Co-Investigator

UCLA School of Public Health, Jonsson Comprehensive Cancer
  Center, Division of Cancer Prevention & Control Research

       Study funded by the National Cancer Institute
             Focus on Korean Americans

2nd highest liver cancer          3rd most populous
  rates among Asians                 Asian group



 Up to 12% of Koreans            Low hep B serologic
  chronically infected              testing rates
      with hep B


                                    No liver cancer
Immigrant population =            prevention efforts
  greater hep B risk              targeting Koreans
         Results of Pilot Study in
           Korean Community
141 Korean Americans from churches and a clinic
Only 56% ever had a hepatitis B test
34% did not know Koreans at higher risk for hepatitis B
Only 36% knew hepatitis B infection can be lifelong
Common barriers to testing
  Fear of a bad diagnosis (75%)
  Cost of test (61%)
  Time (46%)
Church preferred site to receive health information vs.
worksite, clinic, health fair
               Rationale for Church-Based
                      Intervention

  No evidence based                    Adaptation
    programs for                      necessary: for
      hepatitis B                   content & ethnicity



   Church-based
programs successful                       Small group:
 in other minorities                     Cost-efficient &
                                           consistent


    80% of Koreans                    More likely to
     attend church                    be sustained
        regularly                      after grant
                 Study Design
                         Identification of
                        Churches (n = 40)



Intervention Churches                    Comparison Churches
         N=20                                   N=20


 In-Person Baseline                          In-Person Baseline
      Interview                                   Interview
       N = 448                                    N = 448


    Hepatitis B                          Physical Activity/Nutrition
Small Group Session                          Small Group Session




                      6-Month Telephone
                      Follow-up Interview
   The Health Behavior Framework
                INTERVENTIONS

Individual Factors              Barriers/Supports
     Knowledge
  Communication &
 rapport with provider
    Health Beliefs
    Social Support                        Hepatitis B
                         Intentions        serologic
   Cultural Factors
                                            testing
Institutional Factors
 Language differences
 Navigation problems

                              • Demographics
                              • Medical History
                              • Insurance
 Group Intervention Session: Process


            Blend of discussion group
            & educational presentation

            Information presented verbally, visually
               and in-print to enhance interest
               & retention

                              Social norms &
        Group format          Active participation

Culturally competent          Assures acceptance
         intervention         & effectiveness
           Strengths of Projects
Adaptation of existing church based programs focused
on increasing hepatitis B testing

Opportunity to document process of adaptation

Utilizing a rigorous evaluation

Collaboration across CPCRN network sites will allow for:
  Sharing of complementary expertise and experiences
  Understanding of similarities and differences between Koreans
  and Chinese

Lessons learned can be used to adapt programs for other
ethnic groups at risk for hepatitis B and liver cancer

								
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